Clinical oncology (Royal College of Radiologists (Great Britain))
August 13, 2026 · via Europe PMC
Time Trends in Cardiac Doses in 10,000 Patients Receiving Curative Thoracic Radiation Therapy Between 2009 and 2020.
Forbes N, Irankunda BB, Terrones-Campos C, +9 more, Vogelius IR.
AI summary — for doctors, generated from the abstract only
Across 10,215 curative thoracic and breast radiotherapy courses from 2009-2020, cardiac dose decreased significantly over time, especially for esophageal and lung cancers, though heart V5 rose for left-sided breast cancer.
What was studied
Single-institution analysis of 9,966 patients with AI-redelineated hearts, converting cardiac doses to EQD2 and assessing trends by diagnosis.
Key findings
- Highest MHD in esophageal cancer (median 11.67 Gy); lowest in right-sided breast (0.34 Gy) and lymphoma (0.01 Gy)
- Decreasing trend clearest for esophageal and lung cancer; specific statistic not fully captured in the abstract
- Left-sided/bilateral breast cancer heart V5 increased
Clinical relevance
This suggests technological advances and awareness have reduced cardiac exposure, while low-dose spread in left breast RT warrants attention.
Who should care
Limitations
Single-institution data; no linkage to cardiac outcomes.
Heart doses from thoracic radiation have fallen over a decade, though low-dose spread in left breast treatment has grown.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Aims
Cardiac exposure to radiation is associated with an increased risk of cardiovascular morbidity. Radiation therapy technologies have developed to provide target dose coverage with less exposure to adjacent organs. We investigated trends in cardiac exposure among patients treated with curative-intent radiotherapy from a single institution.
Materials and methods
A total of 10,215 treatment courses were analyzed from 9,966 patients treated for intrathoracic or breast cancers in 2009-2020. Hearts were redelineated using an artificial intelligence model to ensure consistency. Cardiac doses were extracted in 3D and converted, voxel-by-voxel, to equi-effective doses in 2 Gy fractions (EQD2) using α/β = 2 Gy. The mean heart dose (in EQD2) and volume exposed to 5 and 40 Gy, respectively, were extracted. Time trends were investigated for each diagnosis.
Results
Patients with esophageal cancer had the highest mean heart dose (median = 11.67 Gy; IQR = 2.85-18.18), while patients treated for right-sided breast cancer (median = 0.34 Gy; IQR = 0.21-0.51) and lymphoma (median = 0.01 Gy; IQR = 0.00-0.38) had the lowest. A decreasing trend over time was seen most clearly for patients with esophageal and lung cancers (P < .05). For left-sided/bilateral breast cancer, volume exposed to 5 Gy increased over time (P = .032).
Conclusion
Radiation exposure to the heart decreased significantly in patients treated between 2009 and 2020, likely due to increased awareness of cardiovascular toxicity and technological developments. For left-sided/bilateral breast cancer, V5 increased significantly, possibly related to increased prioritization of target coverage.
DOI
10.1016/j.clon.2026.104324
PMID
42696943
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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